NR 602 WEEK 5 Practice Questions 2024

54324yo female is dx'd w/primary dysmenorrhea. Which med would be used as first-line to help control symptoms? a. Antianxiety meds b. Progesterone-only contraception c. Oral steroids d. NSAIDs - answersD What is the most common cause of dysfunctional uterine bleeding? a. Endocrine disorders b. Stress c. Anovulation d. Anatomical abnormality - answersC PMS occurs with greatest frequency and severity in the: a. Late luteal phase b. Midfollicular phase c. Proliferative phase d. Early luteal phase d. Early luteal phase - answersA Which is not a common cause of irregular menstrual bleeding? a. Endocrine disorders b. Stress c. Anovulation d. Anatomical abnormality - answersC What is considered the primary etiology of primary dysmenorrhea? a. Ovarian cysts b. Prostaglandin production c. Endometriosis d. Adenomyosis - answersB 28yo female c/o breast tenderness, fatigue, abd bloating, fluid retention, irritability 1wk before her menses onset. What is most important info to obtain from this pt to determine if the pt has PMS? a. Severity of symptoms b. Occurrence of symptoms in menstrual cycle c. Frequency and number of symptoms over past 4mo - answersB 35yo woman c/o 6mo h/o hypermenorrhea, backache, pelvic pressure. On exam, you discover 12wk size uterus w/irregular contour. What does this represent? a. Uterine cancer b. Dysfunctional uterine bleeding c. Uterine fibroid d. Fecal impaction - answersC What phase of menstrual cycle begins with menses cessation and ends w/ovulation? a. Ovulatory phase b. Follicular phase c. Proliferative phase d. Luteal phase - answersB What phase of menstrual cycle begins with ovulation and ends w/menstruation? a. Ovulatory phase b. Follicular phase c. Proliferative phase d. Luteal phase - answersC Name 4 structural abnormalities that are causes of dysfunctional uterine bleeding. - answersPALM: Polyps Adenomyosis Leiomyoma Malignancy Name 5 non-structural abnormalities that are causes of dysfunctional uterine bleeding. - answersCOEIN: Coagulopathy Ovulatory disorders Endometrial Iatrogenic Not classified What is abnormal/dysfunctional uterine bleeding? - answersAcute or chronic bleeding from uterine corpus; abnormal in regularity, volume, frequency, or duration; occurs in pregnancy absence What is ACUTE dysfunctional uterine bleeding? - answersEpisode of sufficient quantity to require immediate intervention to prevent further blood loss What is chronic dysfunctional uterine bleeding (DUB)? - answersPresent for the majority of the last 6mo Name some risk factors for dysfunctional uterine bleeding (DUB)? - answersAnovulation Hormone replacement anovulation Obesity Nulliparity 35yo DM Personal/fam h/o coagulation disorder Liver disorder Anticoagulant therapy/chemo What are some subjective findings for dysfunctional uterine bleeding DUB? - answersHeavy bleeding Bleeding 7 days Cycles closer than 21 days Pain Post-coital bleeding Passing clots/tissue Dizziness Hot flashes Temp intolerance Uterine/cervical tenderness What are some objective findings for dysfunctional uterine bleeding DUB? - answersExcessive bleeding on exam Hypotension Tachycardia Diaphoresis Vag atrophy Mass Trauma Enlarged uterus/adnexa Hirsutism Thyromegaly Bruising Galactorrhea What are some diff dx's for DUB? - answersPALM-COEIN Traumatic injury Pregnancy-related bleeding (ectopic, SAB, placenta previa/abruptio) What are some diagnostic lab studies for DUB? - answers-*Serum hCG: always do first before examining pt of menstruating age w/vag bleeding -CBC -ABO/Rh if preg. suspected/severe bleeding -STD tests/wet prep -Cervical cytology -CMP (w/renal & liver panel) -Coags -If hx indicates: screen for bleeding disorders for DUB at menarche. -If hx indicates: thyroid panel -Endometrial bx What are some diagnostic imaging studies for DUB? - answers-TVUS: first-line if imaging needed -Saline infusion sonohysterography (helpful for leiomyoma) -Hysteroscopy (can be used for guided endometrial bx) -MRI What are some diagnostic studies for polyps in DUB? - answers-TVUS -Saline infusion sonography -Hysteroscopy What is the average age of menarche for Caucasians? - answers12.6 years What are some things that can cause menstrual irregularities? - answers-Disturbances in normal hormone release -Significant wt loss -Strenuous exercise -Substantial changes in sleep/eating habits -Severe stressors Most cycles range from ___________. - answers21-34 days What are the 2 cycles that occur simultaneously in the menstrual cycle? - answersOvarian and endometrial What cycle are follicular, ovulation, & luteal phases? - answersOvarian What phase is menstrual days 1-14 in ovarian cycle? - answersFollicular Prominent hormones: FSH, estrogen Description: maturation of ovarian follicle What phase is menstrual day 14 in ovarian cycle? - answersOvulation Prominent hormones: LH Description: ovulation 36h after LH surge; increased basal body temp What phase is menstrual days 15-28 in ovarian cycle? - answersLuteal Prominent hormones: Progesterone, estrogen Description: follicle becomes corpus luteum Post-coital Bleeding - answersbleeding occu